Rubella : Congenital Rubella Syndrome
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Rubella : Congenital Rubella Syndrome

Congenital rubella syndrome can occur when an non-immunized pregnant woman is exposed to a rubella case, especially in the first four months of pregnancy. Such an infection can cause damage to the developing organs. 


If mother is infected in the first two months of pregnancy there is a 95% chance of fetus being infected, if in the 3rd month 80% chance, if in the 4th month, a 50% chance, the chance decreasing after that.


Incubation period
16 - 18 days. Period of infectivity probably 1 week before and 1 week after the onset of rash.


Signs and Symptoms
Any part of the body of the foetus can be affected, the eyes, ears, heart and nervous system seem to be especially susceptible to damage from a rubella infection.


Diagnosis
Blood tests: Demonstrate IgM rubella specific antibodies.


Treatment
If pregnant mother is in contact with a rubella patient, a blood analysis on the Ig status of the patient is carried out. If IgG is present and IgM is absent indicates past infection. If IgG is absent and IgM is present indicates recent infection. Anti-Rubella Ig given to pregnant mother at any stage of pregnancy under specialist advice, dosage according to body weight.


Control and Prevention
Educate public on the need for immunization. Single dose of live attenuated virus before pregnancy is recommended. Vaccine is recommended to all susceptible premarital and mothers with advice not to get pregnant for at least 3 months after taking the vaccine. In Malta vaccine is recommended to have a second dose at 7 years of age as part of the MMR in the second year of life. Vaccine is not recommended to persons with an immunodeficiency or on immunosuppressive therapy and pregnant women. Infected persons should be isolated from work, from school, and nursed in isolation in hospital for 7 days before and after the onset of rash.